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HTH Romero Midterm
HTH Romero Midterm - Rau's
137
Pharmacology
10/18/2011

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Term
Generic substitutes tend to be less expensive than proprietary brands because the generic manufacturer has not invested the considerable time and money necessary to develop the original drug product.
Definition
True
Term
If generic substitution is permitted on a prescription:
Definition
Any manufactured brand of the drug listed may be given.
Term
The study of drugs, including their origin, properties, and interactions with living organisms, is known as:
Definition
Pharmacology
Term
Brand name given to drug by manufacturer is known as the drug’s:
Definition
Trade name
Term
To find official information about drugs (according to the FDA), go to:
Definition
US Pharmacopeia–National Formulary (USP–NF)
Term
Drugs may be obtained from which of the following sources?
Definition
Plants, animals, and minerals
Term
The branch of the U.S. government responsible for the process of approving drugs for clinical use is the:
Definition
FDA
Term
An orphan drug is a drug that:
Definition
Is used for rare disease
Term
Drugs available to general public without a prescription are known as:
Definition
Over-the-counter drugs
Term
Advantages of delivering drugs by oral or nasal inhalation include?
Definition
Aerosol doses are smaller than those administered systemically. Side effects are usually fewer and less severe. The onset of action is rapid. The delivery process is painless, relatively safe, and usually more convenient.
Term
Which of the following classes of drugs can be aerosolized?
Definition
Antiasthmatic agents, Adrenergic agents, Anti-infective agents, Mucoactive agents, Corticosteroids
Term
Which of following drug groups are important to respiratory & critical care, although they may or may not be available in an aerosol form?
Definition
Diuretics, Antiarrhythmic agents, Neuromuscular blocking agents, Anticoagulant and thrombolytic agents
Term
In today’s market, companies spend approx. how much money on research, development, preclinical and post-clinical trials?
Definition
$900 million
Term
If drug ordered with the Latin abbr. qid, it should be administered:
Definition
Four times daily
Term
If a physician desires a drug to be administered as needed, he or she should use which of the following abbreviations?
Definition
prn
Term
A drug’s portal of entry into the body is known as its:
Definition
Route of administration
Term
Which of the following is not a route of drug administration?
Definition
Ointment
Term
Which of following methods of drug administration do not require hypodermic needle?
Definition
Transdermal, Inhalation, Subcutaneous, Intravenous
Term
Which of following is not part of the pharmacokinetic phase of a drug?
Definition
Receptor site
Term
The principal organ for drug metabolism is the:
Definition
Liver
Term
Which following organs is considered primary site of drug excretion?
Definition
Kidney
Term
The mechanism of drug action by which a drug molecule causes its effect in the body is known as the:
Definition
Pharmacodynamic phase
Term
albuterol binds to its corresponding receptor in order to initiate its intended response of bronchodilation. albuterol is known as a:
Definition
Agonist
Term
Two different drugs (each with its own mechanism of action) are administered to a patient in attempt to relieve bronchoconstriction. The ordering physician hopes that effect of drug pair will be greater than sum of separate effects of each drug. If successful, this will be:
Definition
Synergism
Term
a 37-year-old female has been taking medication for lower back pain for last 18 mo. She reports that although medication initially rendered her pain-free, she now receives very little relief from daily dose. This describes which term used to describe drug responsiveness (assuming condition has not worsened):
Definition
Tolerance
Term
Match the following Greek prefixes with their meaning.
Definition
Deca :10 , Kilo :1000 , Hecto :100
Term
Atrovent is supplied as a 0.02% solution. If you administer 2.5 ml to a patient, how many milligrams are you giving?
Definition
0.50
Term
A physician orders 3 ml of an 8% drug solution. You only have a 10% solution available. How many milliliters of 10% solution do you need to make the new 8% solution?
Definition
2.4 ml
Term
Traditionally, what percentage of a given dose of aerosolized medication reaches the lower respiratory tract, regardless of the type of delivery device being used?
Definition
10%-15%
Term
For pulmonary diagnostic and therapeutic applications, the particle size range of interest is what?
Definition
1 to 10 mm
Term
You have 3 mg/ml of active ingredient; what is the percent solution of this drug?
Definition
0.30000%
Term
Match following Units terms with the unit of measurement.
Definition
Volume :Cubic meter , Mass :Kilogram
Term
patient carries albuterol MDI, which she uses every few weeks. complains that first dose seems to have no effect on bronchospasm. What suggestion would you make to correct the problem?
Definition
Discharge a waste dose before using the MDI.
Term
You are instructing the parents of a 4-year-old child with asthma on how to deliver aerosolized medication at home via a traditional small-volume jet nebulizer. When asked how much of the medication actually reaches the child’s lungs, you answer:
Definition
10% to 15% of the total drug dose
Term
An aerosol is best defined as:
Definition
A suspension of solid or liquid particles in a carrier gas
Term
One milliliter (ml) is equal to how many drops (gtts) of liquid?
Definition
16
Term
You have atropine 0.4 mg/ml in a vial of liquid. How many milliliters will be needed for a 1.0-mg dose?
Definition
2.50
Term
You administer 0.5 ml of a 1:200 strength drug; how many milligrams of active ingredient are you giving?
Definition
2.5 mg
Term
One cubic centimeter is equivalent to how many milliliters?
Definition
1
Term
How many cubic centimeters do you need for a 2.5-mg dose of terbutaline sulfate, using a 0.1% solution?
Definition
2.50
Term
What is the purpose of the end-inspiratory breath-hold used in conjunction with aerosol delivery?
Definition
Allows better deposition through gravitational settling
Term
How much 20% acetylcysteine needed for 5 ml of 6% solution?
Definition
1.5 ml
Term
Your patient informs you that she keeps her albuterol MDI stored in her refrigerator, for she feels that this may keep the medication “fresher” for a longer period of time. What is your response?
Definition
Request that she no longer refrigerate the canister, but store it at room temperature.
Term
Match the following Latin prefixes with their meaning.
Definition
Micro :1/1,000,000 , Milli :1/1000 , Centi :1/100 , Deci :1/10
Term
A physician orders that 12 mg of medication be delivered to your patient. If 30 ml of the solution contains 20 mg of active drug, how many milliliters will you need to administer?
Definition
18
Term
Three main uses of aerosol therapy include the following:
Definition
Humidification of dry gases, Improved mobilization and clearance of secretions, Delivery of aerosol drugs to the respiratory tract
Term
Match following metric system terms with quantities they measure.
Definition
Meter :Length , Liter :Volume , Gram :Mass
Term
Adrenergic bronchodilators mimic the actions of:
Definition
Epinephrine
Term
Epinephrine stimulates which sites?
Definition
A, b1, b2
Term
All of the following are side effects that should be monitored in your patient when using a sympathomimetic aerosol except:
Definition
Bradycardia
Term
Your patient presents with postextubation stridor. You recommend racemic epinephrine for its:
Definition
a-Adrenergic vasoconstricting effect
Term
What is the indication for use of a short-acting b agonist in asthma?
Definition
As rescue therapy in reversible airflow obstruction
Term
In the parasympathetic branch of the nervous system, what name is given to the neurotransmitter that conducts nerve transmission at the ganglionic site?
Definition
Acetylcholine
Term
Short-acting b2 agonists are indicated for:
Definition
Relief of acute reversible airflow obstruction
Term
You enter the room of a 2-year-old patient who presents with the characteristic “barking cough” found with croup. Once the diagnosis is confirmed, you may recommend which of the following medications to help provide relief from subglottic swelling?
Definition
Racemic epinephrine
Term
Relaxation of smooth airway muscle in the presence of reversible airflow obstruction is a general indication for the use of:
Definition
Adrenergic bronchodilators
Term
You are treating an asthmatic who also happens to be taking propranolol (a b blocker) for a history of cardiac arrhythmias. What effect would you expect albuterol to have on this patient?
Definition
Little or no effect
Term
Your patient is suffering from bradycardia. Which type of drug do you recommend?
Definition
Sympathomimetic
Term
The stimulation of which receptor sites produces bronchial smooth muscle relaxation?
Definition
b2
Term
Inhalation is the preferred route of administering catecholamines for which of the following reasons?
Definition
Rapid onset of action, Smaller dosage used, Reduced side effects, Drug is delivered to target organ, Safe and painless route
Term
You are ordered to extubate a mechanically ventilated patient who has recently undergone open-heart surgery. On postextubation assessment, you note that the patient has stridor with mild retractions. Pharmacologically, you would recommend:
Definition
a-Adrenergic
Term
Epinephrine stimulates which of the following receptor sites?
Definition
A, b1, b2
Term
Your patient is accidentally given a large dose of a parasympathomimetic drug. What side effects of parasympathetic overstimulation do you expect to see?
Definition
Salivation, Lacrimation, Urination, Defecation
Term
Levalbuterol is:
Definition
The single (R)-isomer of albuterol
Term
Disease states that could benefit from the use of adrenergic bronchodilators include which of the following?
Definition
Asthma, Bronchitis, Emphysema, Bronchiectasis
Term
The bronchodilating action of adrenergic drugs is due to stimulation of:
Definition
b2 Receptors
Term
Albuterol is available in which of the following forms?
Definition
Syrup, Nebulizer solution, Metered dose inhaler (MDI), Oral tablets, Dry powder inhaler (DPI) capsules
Term
How is the neurotransmitter acetylcholine inactivated at the parasympathetic terminal receptor site?
Definition
By the enzyme cholinesterase
Term
b1 Receptor stimulation will:
Definition
Increase heart rate and contractile force
Term
Your patient is diagnosed with persistent asthma. Which type of drug would you recommend for maintenance bronchodilation and control of bronchospasm?
Definition
Long-acting adrenergic agent
Term
A patient with glottic edema is in mild distress. Which of the following medications would be of benefit in this situation?
Definition
Racemic epinephrine
Term
Your patient is receiving her third continuous nebulizer of albuterol (15 mg/hr.). Which potential complications should you be on the lookout for?
Definition
Hypokalemia, Cardiac arrhythmias, Hyperglycemia, Premature ventricular contractions (PVCs), Tremor
Term
What is the only b-agonist formulation that is a single isomer and is approved by the U.S. Food and Drug Administration (FDA) for aerosol delivery?
Definition
Levalbuterol
Term
After administering a sympathomimetic drug to your patient, in what areas would you expect to see an upward trend?
Definition
Heart rate, Blood pressure, Blood sugar
Term
You administer an inhaled bronchodilator that is known to have adrenergic side effects on the heart. What clinical sign should you watch for in your patient?
Definition
Tachycardia
Term
What is the adrenergic effect on bronchial smooth muscle?
Definition
Dilation (relaxation)
Term
Salmeterol is:
Definition
A long-acting b-adrenergic
Term
Atrovent is approved for:
Definition
Maintenance treatment of airflow obstruction in COPD
Term
The physical properties of mucus include which of the following?
Definition
Adhesion, Cohesion, Elasticity, Viscosity
Term
Which of the following agents is/are currently approved for administration as an aerosolized mucoactive agent?
Definition
N-acetylcysteine (NAC), Dornase alfa
Term
Theophylline and caffeine are examples of:
Definition
Methylxanthines
Term
It is difficult to determine therapeutic doses of theophylline because:
Definition
Individuals metabolize theophylline at different rates.
Term
How does acetylcysteine work?
Definition
Substitutes sulfhydryl radicals for disulfide bonds in mucus
Term
Theophylline has been used to treat all of the following except:
Definition
Pneumonia
Term
Acetylcysteine is incompatible in solution with which of the following:
Definition
Certain antibiotics
Term
Common, less toxic side effects of theophylline therapy include which of the following?
Definition
Headache, Gastric upset, Anxiety, Nervousness, Diuresis
Term
The only anticholinergic that is approved by the U.S. Food and Drug Administration (FDA) for aerosolization is:
Definition
Ipratropium bromide
Term
Cardiac effects of aerosolized ipratropium bromide include:
Definition
Little or no effect
Term
The currently recommended blood serum theophylline level for the management of asthma is:
Definition
5 to 15 mg/ml
Term
Pulmozyme is the trade name for the mucoactive agent:
Definition
A)      Dornase alfa
Term
The recommended therapeutic blood serum range of theophylline for use in the treatment of chronic obstructive pulmonary disease (COPD) is:
Definition
10 to 12 mg/ml
Term
What is the only once-a-day anticholinergic on the market?
Definition
Tiotropium bromide
Term
Dosage of theophylline is best monitored by:
Definition
Measurement of serum drug levels
Term
You have a patient with chronic obstructive pulmonary disease (COPD) who is struggling to expel viscid mucus plugs. What would you recommend for the problem?
Definition
Acetylcysteine
Term
Patients using ipratropium aerosols should be instructed to avoid allowing the aerosol in contact with their:
Definition
Eye
Term
Combivent is a combination drug including which agents?
Definition
Albuterol and Atrovent
Term
The most common side effect of anticholinergic bronchodilators is:
Definition
Dry mouth
Term
How does dornase alfa work?
Definition
Breaks down DNA content in sputum
Term
Disadvantages of theophylline therapy include which of the following?
Definition
Narrow therapeutic margin, Toxic effects, Unpredictable blood levels, Need for individual dosing, numerous drug–drug and drug–condition interactions
Term
Possible side effects of aerosolized Atrovent include which of the following?
Definition
Flulike symptoms, Pharyngitis, Dry mouth, Dyspnea
Term
Which of the following is not a function of mucus in the body?
Definition
Improvement of gas exchange
Term
The xanthine of choice to treat apnea of prematurity is:
Definition
Caffeine citrate
Term
A resident orders 4 cc of 20% Mucomyst aerosolized for an asthma patient. You are called by the unit secretary about the order. You would:
Definition
Call the resident and obtain a verbal order to give a b2 agonist with the Mucomyst
Term
All of the following are hazards associated with the use of acetylcysteine except:
Definition
Tachycardia
Term
The therapeutic range for theophylline is:
Definition
10–20 mg/ml
Term
Results of your patient’s pulmonary function test (PFT) show that the peak flow rate increased the most when she inhaled an aerosolized sympathomimetic agent and an aerosolized parasympatholytic agent. You would recommend that she be given:
Definition
Combivent MDI
Term
The mechanism of action by xanthines is:
Definition
Unclear
Term
The product combining an inhaled steroid and a bronchodilator is:
Definition
Advair
Term
Pentamidine is a (n):
Definition
Antiprotozoal agent
Term
Corticosteroids are used with asthmatics and COPD patients to achieve which effect?
Definition
Anti-inflammatory
Term
A patient complains of oral thrush and hoarseness since she has been using fluticasone by MDI. The physician asks you to make a suggestion to help her without discontinuing the drug. You suggest:
Definition
Add a spacer and rinse the mouth after use
Term
Cromolyn sodium is effective in preventing bronchospasm by:
Definition
Inhibiting mast cell degranulation
Term
A patient has been taking oral prednisone for 1 week following a severe episode of asthma. The physician decides to switch the patient to aerosolized beclomethasone (QVAR). What is the best way to accomplish this?
Definition
Begin the aerosol and begin to gradually taper off of the oral dose.
Term
Inhaled pentamidine is indicated for:
Definition
Prevention of PCP
Term
General indication 4 clinical use of nonsteroidal antiasthma agents:
Definition
Prophylactic management of mild persistent asthma
Term
The nebulizer used to aerosolize ribavirin is the:
Definition
SPAG
Term
Which of the following is considered a mast cell stabilizer?
Definition
Cromolyn sodium
Term
The usual dose of nebulized cromolyn sodium is:
Definition
20 mg four times per day
Term
Local airway side effects of aerosolized pentamidine include which of the following?
Definition
Wheezing, Coughing, Shortness of breath, Bad taste, Spontaneous pneumothoraces
Term
The trade name for aerosolized pentamidine is:
Definition
NebuPent
Term
Ribavirin is classified as a (n):
Definition
Bacteriostatic
Term
The trade name for ribavirin is:
Definition
Virazole
Term
Major cells responsible for inflammatory response in asthma are:
Definition
Mast cells and eosinophils
Term
The mode of action of pentamidine is:
Definition
Unknown
Term
The brand name for cromolyn sodium is:
Definition
Intal
Term
Pentamidine is administered by aerosol with which nebulizer?
Definition
Respirgard II
Term
Side effects of aerosolized steroid use incl. all the following except:
Definition
Osteoporosis
Term
Respiratory syncytial virus (RSV) can cause which of the following?
Definition
Bronchiolitis, Pneumonia
Term
In COPD, the primary inflammatory cells are:
Definition
Neutrophils
Term
Your patient tells you that she is having chest tightness and wheezing 4 to 6 times/week, plus she wakes up with chest tightness and wheezing about once per week. She uses albuterol each time, with relief. She is taking no other medication, except her albuterol MDI. What other medication would you suggest be prescribed to her?
Definition
Beclomethasone MDI
Term
Nonsteroidal antiasthma drugs are:
Definition
Controllers
Term
The disease that aerosolized antibiotics have been most consistently used for is:
Definition
Cystic fibrosis
Term
After a patient begins using cromolyn sodium, how long may it take before clinical improvement in patient symptoms is seen?
Definition
2 to 4 weeks
Term
Systemic side effects of aerosolized pentamidine can include which of the following?
Definition
Pancreatitis, Conjunctivitis, Neutropenia, Renal insufficiency, Rash
Term
A patient with Pneumocystis pneumonia has been systemically treated, without success. You recommend aerosolizing:
Definition
Pentamidine
Term
Which of the following is a common side effect of inhaled corticosteroids?
Definition
Oral candidiasis
Term
Zanamivir would be indicated for:
Definition
Uncomplicated influenza